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The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China
  1. Raju Sapkota1,
  2. Zhiqing Chen2,
  3. Dingchang Zheng3,
  4. Shahina Pardhan1
  1. 1Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
  2. 2Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
  3. 3School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Chelmsford Campus, Chelmsford, UK
  1. Correspondence to Dr Shahina Pardhan; shahina.pardhan{at}anglia.ac.uk

Abstract

Background/aims To examine the profile of diabetic retinopathy, awareness and self-help in patients attending a specialist eye clinic in Hangzhou, China.

Methods A total of 199 consecutive patients with diabetes (mean age = 57 years, SD = 11) attending eye clinic at the School of Medicine, Zhejiang University, Hangzhou were examined in a cross-sectional study. Clinical/demographic data were obtained from patients’ records. Fundus photographs obtained from each patient were graded using Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria; severe non-proliferative, proliferative retinopathy and/or macular oedema (hard exudates/thickening around fovea) were classified as sight-threatening diabetic retinopathy (STDR). Optical coherence tomography was used to confirm the diagnosis of macular oedema. Data on knowledge/awareness about diabetes and self-help/lifestyle were collected using a structured questionnaire.

Results STDR was found in 80% patients of whom 18% had visual acuity of ≤counting fingers in at least one eye. Male gender, longer diabetic duration and use of insulin were significantly associated with STDR (p ≤ 0.05). Of the total, 41% patients reported that they were attending for the first time. Of all the first-time attendees, 67% had STDR. Also of all the first-time attendees, 14% were unclear whether diabetes affected their eyes. Fifty-one per cent of patients who thought their diabetes was well controlled had fasting blood sugar ≥6.5 mmol/L (p < 0.001). Of the total, 65% patients reported not doing ≥4 hours/week of physical exercise.

Conclusions The majority of patients with diabetes presented to this eye clinic suffered with late-stage retinopathy. Our results advocate the need to improve diabetic diagnosis, management and awareness and to set up eye screening for diabetics in Hangzhou, China.

  • diabetes
  • sight– threatening and non-sight threatening retinopathy
  • awareness about diabetes
  • self-help

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors SP and RS conceived and designed the study. ZC and DZ did questionnaire translations. ZC collected data. RS and SP analysed the data: RS, SP, DZ and ZC wrote and revised the paper.

  • Funding This work was supported by Anglia Ruskin University grant number YR51 AY000.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics Committee of the Second Affiliated Hospital, School of Medicine, Zhejiang University. Approval Number: 2016-013.

  • Provenance and peer review Not commissioned; externally peer reviewed.